tempus fugit

Mr. Trump announced his plans to “lower” drug prices over the weekend– claiming to fulfill his campaign promises while continuing to pave the way for drug manufacturers to remain profitable. For most of us, Mr. Trump’s scandals have overshadowed anything he could present as a “policy”– but that hasn’t stopped him from continuing his catastrophic misrule and bigoted, sometimes hysterical pronouncements. His scandals have distracted those who already know he is too corrupt and too narcissistic to be president, while he quietly destroys the government and institutes hateful right-wing policies.

During the presidential campaign, Mr. Trump promised to lower drug prices, a very popular position because of people’s wide– and accurate– perception of being over-charged for medicine. The most popular tactic Mr. Trump offered was a proposal to introduce negotiations between government payers and drug manufacturers to lower prices in return for market share in the Medicare Part D program. Many people– especially those over 65– were already aware that Mr. Bush’s original Part D plan had specifically prohibited the government from negotiating price breaks on medication covered by Part D. Many people– especially veterans– knew that the Veteran’s Administration had a very effective program of price negotiations and a preferred formulary; people wondered why the same couldn’t be done for Part D.

More than a year after his administration has begun, Mr. Trump has finally gotten around to discussing his proposals for the problem of high drug prices in the US. The idea of negotiating prices and creating a preferred drug list for Medicare Part D has been forgotten (although it was probably the most effective among his proposals.) Instead, one of Mr. Trump’s most prominent proposals today is to force people in other countries to pay higher prices– because, according to him, the governments of other countries, by regulating drug prices and negotiating terms with drug companies, have been unfairly paying less than Americans for drugs.

This proposal appears to have been lifted directly from a drug industry playbook. Penalizing other countries for controlling drug prices– because they are unfairly forcing Americans to pay more by leaving the drug companies an unregulated market in the US?? The delusion is that American consumers are “subsidizing” Europeans, who are cheating by not paying drug companies enough for their product. Clearly, this hallucinatory proposal suits Mr. Trump’s nationalist and pro-business prejudices well.

Wouldn’t it be fairer to the public for the US government to join in on this negotiation with drug companies to try to get some of the same discounts? Surely drug companies can be induced to lower some of their prices and cooperate for a more rational allocation of drugs overall. The shareholders need to temper their greed a little.

The rest of Mr. Trump’s proposals to “control” drug prices are either irrelevant or ineffective. One proposal is to change the way patents are handled– to stop companies from exploiting protection beyond the twenty-year exclusive (up from seventeen years) that patents now provide. Some companies have refused to provide any samples of their patented drugs to other companies, making it impossible for them to do FDA-required comparability studies. Other companies have made trivial alterations in their products to create “new” formulations that can be patented again for another twenty years. These tricks and many others are legal even though they are obviously anti-competitive; attorneys general have not seen fit to investigate. How Mr. Trump intends to stop these practices is unclear, but this is really an area where a lot of savings cannot be expected.

In the meantime, Mr. Trump’s proposals make no mention of artificial shortages created by the decisions of managers not to perform required maintenance on their production equipment until the equipment breaks down and the lines have to be closed for months at a time. Naturally, the shortages create additional opportunities for price increases.

Mr. Trump is trying to deflect the attention of his voters by pretending to follow through on his campaign promises without hurting the bottom line for his friends who are CEO’s of drug manufacturers. He has seen handsome rewards from the drug companies– compensation that has not become public due to the risk of a backlash from his voters. Mr. Trump is in desperate need of distractions since the Stormy Daniels scandal has mushroomed with the revelation of his lawyer’s slush fund.

No wonder Novartis paid into Michael Cohen’s limited liability company, Essential Consultants, to “consult” for the new president. There is no telling how many more payoffs the drug companies have secretly provided to the president who claims to be so rich that he can’t be corrupted by bribes.